Islamabad: Pakistan is spending more than Rs12 billion annually, equivalent to about $43 million, on anti-rabies vaccines (ARVs), rabies immunoglobulin and related treatment, as over 600,000 people are bitten by stray dogs every year and preventable rabies deaths continue to be reported, highlighting what public health experts describe as a costly failure of prevention.
Health officials estimate that Pakistan requires around 2.4 million doses of anti-rabies vaccine and at least 180,000 doses of rabies immunoglobulin each year to meet post exposure treatment needs arising from dog bites.
These figures are based on conservative calculations using officially reported cases and standard treatment protocols, and experts warn the real requirement is likely higher due to underreporting.
According to disease surveillance data compiled from weekly Integrated Disease Surveillance and Response bulletins of the National Institute of Health, more than 600,000 dog bite cases were recorded across the country in 2025, with Sindh and Punjab accounting for the overwhelming majority.
Nearly 40 percent of Sindh’s cases or around 110,000 were reported from Karachi alone, underscoring the scale of the crisis in major urban centres.
Punjab, which does not report dog bite cases through the federal surveillance system, separately recorded around 277,000 incidents by late October, averaging more than 900 bites every day, according to provincial figures cited in official records and regional media. At least eight confirmed rabies deaths were reported from Punjab this year, the highest annual number on record for the province.
Public health experts warn that even these alarming numbers represent only a fraction of the true burden, as dog bites are widely underreported, particularly in low income urban settlements and rural areas where victims often seek treatment from private clinics, turn to traditional healers, or do not seek care at all.
Under World Health Organization (WHO) recommended guidelines, every suspected rabies exposure requires four doses of anti-rabies vaccine, while severe category three bites also require rabies immunoglobulin at the first visit. Based on reported cases alone, Pakistan’s annual vaccine requirement reaches approximately 2.4 million doses, while immunoglobulin needs are estimated at around 180,000 doses, assuming 30 percent of bites fall into the severe category.
At prevailing government procurement prices, anti rabies vaccines cost Rs1,200 to Rs1,500 per dose, placing the annual vaccine bill at Rs3 to 3.6 billion. Rabies immunoglobulin, one of the most expensive and frequently scarce components of treatment, costs Rs40,000 to Rs50,000 per dose, pushing annual immunoglobulin spending to Rs7.2 to 9 billion.
Together, vaccines and immunoglobulin alone cost more than Rs10 to 12.5 billion every year, without accounting for emergency room visits, repeat hospital appointments, cold chain logistics, staff time and treatment of complications. Converted at current exchange rates, this amounts to roughly $35 to $45 million annually.
Most of Pakistan’s rabies vaccines and immunoglobulin are imported, primarily from Indian and Chinese manufacturers through local pharmaceutical importers, making rabies prevention heavily dependent on foreign supplies. While these products save lives, experts say the country has become trapped in a cycle of repeated imports because it has failed to address the root cause of exposure.
“This is money spent on firefighting rather than prevention,” said Dr. Asim Ahmed, a senior public health expert involved in rabies surveillance. “If even a fraction of this annual expenditure was invested in sustained dog vaccination, sterilisation and waste management, the number of bites would fall sharply within a few years.”
Despite rabies being entirely preventable, Pakistan continues to report human deaths every year, largely due to delayed treatment, incomplete vaccination and shortages of immunoglobulin at public hospitals. When supplies run out, poor patients are often forced to purchase costly injections from private pharmacies or abandon treatment altogether, with fatal consequences.
Federal health officials have repeatedly flagged Punjab’s absence from the national disease surveillance system as a major weakness, limiting accurate forecasting of vaccine and immunoglobulin needs and complicating national planning.
Experts warn that unless provinces shift focus from emergency injections to preventive dog population control, Pakistan will continue to spend billions of rupees every year on vaccines and immunoglobulin, while a completely preventable disease keeps biting into public finances and claiming lives.
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